Probiotics and uremia (益生菌和尿毒症)

Hi,

Uremia is one unwanted complication that may happen in patients of endstage renal diseases (ESRD). For the past several decades, different approaches have been adopted to tackle it. A few are based on the use of enzymes or bacteria to remove the toxic metabolic wastes. Recently, an enteric coated capsule containing live bacterial cells has been indicated to have good result for a limited number of predialysis kidney patients (stage 3 and 4). Its veterinary version has received some positive feedback from owners of felines or canines suffering from kidney failure.

It is also important to point out that in the use of probiotics, formulation is important to its success. Enteric version of delayed-release to allow optimal bacterial action in colon may work well as gut-based alternate kidney if the bacterial species selected are sensitive to habitat such as pH environment (gastric pH 1 versus intestinal pH 7). Also, dosing of culture in colony-forming unit (cfu) may also be relevant (billion cfu vs million cfu). Furthermore, an appropriate selection of bacteria can be crucial to the success of probiotics. As a result, any OTC probiotics for colon comfort or gas relief may not always be suitable for kidney patients in relieving symptoms of uremia. It may also be good to choose a symbiotics (i.e. a probiotics that also contains a prebiotics which can be some sort of fiber serving as nutrient for the probiotic bacteria). For probiotics to work, bowel movement is important. So, it would be better if we can check with our doctors before taking any probiotics and make sure we have an elimination mechanism for toxic waste.

Ref:

http://www.dovepress.com/potentials-and-limitations-of-microorganisms-as-renal-failure-biothera-peer-reviewed-article-BTT-recommendation1

http://informahealthcare.com/doi/pdf/10.1185/03007990903069173

http://www.kibowbiotech.com/pdfs/abstract%203.pdf

http://www.advancesintherapy.org/ait/images/uploads/AIT609_Ranganathan_for_web.pdf

http://www.kibowbiotech.com/pdfs/Probiotic%20Amelioration%20of%20Azotemia%20in%205-6th%20Nephrectomized%20Sprague%20Dawley%20Rats.pdf

L-arginine / L-citrulline in Blood Pressure Control

Hi,

In my earlier posting of agents for blood pressure (BP) control, I have referenced some papers on the use of L-arginine / L-citrulline for potential roles in BP reduction. Would like to emphasize that the use of these dietary supplements should be carefully discussed with healthcare providers and monitored. Both compounds act as precursors to facilitate nitric oxide production which may leads to endothelial dilation of blood vessels, thus lowering BP. However, they may also produce the tissue-damaging NO radical that is disadvantageous. Also, they may produce more nitrogenous waste products such as urea in the nitrogen cycle. It is hard to predict which way the two agents will act in our body upon consumption. That may be highly dependent on our physiological condition and health status. So, I would like to point this out here. There is always a risk of taking in agents of unclear mechanisms.